October 07, 2026 - 243 views
The Welsh Ambulance Service has made significant progress since previous inspections, but delays handing patients over to hospitals remain a major challenge — with hospitals in North Wales continuing to experience significant pressure.
A new assessment by Healthcare Inspectorate Wales found that Welsh Ambulance Services University NHS Trust is now in a “materially stronger position” than it was when it was previously reviewed in 2020 and 2021.
Inspectors highlighted improvements in leadership, staff support, clinical decision-making, digital systems and the way the service manages periods of particularly high demand.
There has also been progress in finding alternatives to hospital emergency departments for some patients, allowing them to receive appropriate care without necessarily travelling to A&E.
But hospital handovers remain a significant problem.
HIW said delayed ambulance handovers remain the “most significant challenge” facing the service and continue to present a risk across the urgent and emergency care system.
The problem is particularly relevant to North Wales, where hospitals including Ysbyty Gwynedd, Ysbyty Glan Clwyd and Ysbyty Maelor serve large and geographically dispersed communities.
When an ambulance crew is forced to wait for a patient to be accepted into hospital care, that ambulance is effectively unavailable to respond to another emergency in the community.
HIW's assessment acknowledges that handover delays are not a problem WAST can solve on its own. They are closely linked to pressures across the wider NHS, including emergency department capacity, patient flow and the availability of appropriate care and support elsewhere in the health and social care system.
There are signs of improvement, however.
HIW noted that ambulance handover performance had improved, with handover lost hours in November 2025 falling to their lowest level in four years.
The inspectors also found that WAST had strengthened clinical decision-making and developed alternative pathways intended to help some patients access appropriate care without having to attend an emergency department.
Those changes are significant because pressure on emergency departments can quickly feed through into ambulance availability.
For North Wales, where patients may already face considerable travel distances to specialist services, keeping ambulances moving is particularly important.
The Welsh Ambulance Service has also faced periods of intense demand. In 2026, the service declared a critical incident following a sustained increase in demand, illustrating the pressures that can develop rapidly across the emergency care system.
HIW's latest assessment nevertheless represents a more positive picture than previous inspections.
The inspectorate said WAST had made “significant progress” since the earlier reviews and that many of the improvements were now embedded within routine governance and operational practice.
That includes improvements in leadership and governance, workforce support, clinical decision-making and the use of digital information.
The challenge now is demonstrating that those improvements translate into better experiences and safer outcomes for patients.
HIW has made recommendations covering patient safety, patient experience, staff development, organisational learning and data quality, and says it will continue to monitor progress.
For people across North Wales, one of the clearest measures of success will be whether ambulances can spend less time waiting outside hospitals and more time available to respond to emergencies in the communities they serve.
The latest report suggests progress has been made — but it also makes clear that hospital handover delays remain a problem requiring action across the whole health and social care system.
